1. Field
Aspects herein relate to the application of tensile force to a tissue region, such as a portion of the gastrointestinal system.
2. Discussion of Related Art
Esophageal atresia is a medical condition where a section of the esophagus is missing. Esophageal atresia may be congenital where, for example, a proximal esophagus portion ends in a pouch rather than connecting normally to the stomach. Or, esophageal atresia may arise due to a surgical need to remove a segment of the esophagus. As shown in FIG. 1, the esophagus 10 is split into a proximal esophagus portion 12 and a distal esophagus portion 14, failing to provide a continuous passageway from the mouth 16 to the stomach 18.
Treatment for esophageal atresia may involve connecting the two end segments of the esophagus to each other. This is usually done through a series of incisions between the ribs on the right side of the child and mechanically manipulating the proximal and distal segments of the esophagus so as to ultimately be joined through surgical anastomosis. In some cases, called long-gap esophageal atresia, the gap between proximal and distal esophageal segments may be excessive (e.g., greater than 3 cm long) and cannot be corrected during a single surgery. For long-gap esophageal atresia, various surgical approaches have been used, such as removal and insertion of another digestive segment of the patient, such as the colon or jejunum.
An advanced surgical treatment called the Foker method has been used to elongate and then join together the esophageal segments, typically when the patient is at 3 months of age or older. When using the Foker method, surgeons stitch traction sutures 50 into the esophageal ends 12, 14 at respective locations 52, 54. The sutures 50 are wrapped around the ribs 20, which are used as pulleys, and tied off outside of the back of the patient. The suture loops are tightened daily so as to cause stretching or growth of the respective esophageal segments until the ends are close enough to be joined together. A shortcoming of the Foker method is that the patient needs to be kept paralyzed and sedated for the entire duration of treatment where traction forces are applied, which is commonly 1-4 weeks. Otherwise, absent paralysis and sedation, certain types of motion of the rib cage may result in undesirable tearing of the sutures out of the respective esophageal segments to which they are attached. Though, paralysis and sedation for such long periods of time may lead to increased risk in patient morbidity (e.g., pneumonia, bone loss, etc.).